Reproductive Health Law in the Philippines
Hon. Esperanza I. Cabral, MD
Former Secretary of Health, Republic of the Philippines
April 23, 2013
ABSTRACT
The Philippines has recently passed a law on Responsible Parenthood and Reproductive
Health after several decades of controversy and public debate. This article summarizes the
elements of the Reproductive Health Law, as well as the arguments for and against its
enactment.
INTRODUCTION
The Philippine Congress enacted Republic Act No. 10354 on Responsible Parenthood and
Reproductive Health on December 18, 2012, after decades of what can only be described as
“bitter public controversy and political wrangling.” Three days later, it was signed into law by
the President of the Philippines. 1 Commonly known as the Reproductive Health (RH) Law, its
Implementing Rules and Regulations (IRR) were due to come into effect on Easter Sunday,
March 31, 2013. However, just 10 days before that, the Supreme Court of the Philippines issued
a status quo ante (or restraining) order against the RH Law for 120 days,2 during which period it
would review the petitions challenging the new law itself; oral arguments before the Supreme
Court had been set to begin on June 18, 2013, or six months since the enactment by Congress.
This paper gives an outline of the elements of the new RH Law, and closes with a revisit of the
many arguments and counter-arguments made for and against the Bill then, and the Law now.
The Elements of the RH Law
What are the elements of the recently enacted RH Law? They are:
(1) Family planning information and services;
(2) Maternal, infant and child health and nutrition, including breast feeding;
(3) Prevention of abortion and management of post-abortion complications;
(4) Adolescent and youth reproductive health guidance and counseling;
(5) Prevention and management of reproductive tract infections (RTIs), HIV/AIDS and sexually
transmittable infections (STIs);
(6) Elimination of violence against women and children and other forms of sexual and gender-
based violence;
(7) Education and counselling on sexuality and reproductive health;
(8) Treatment of breast and reproductive tract cancers and other gynecologic conditions and
disorders;
(9) Male responsibility and involvement and men’s RH;
(10) Prevention, treatment and management of infertility and sexual dysfunction;
(11) RH education for the adolescents; and
(12) Mental health aspect of reproductive health care.
Arguments for the RH Law
Reproductive Health proponents and supporters such as 30 professors of the University
of the Philippines School of Economics,4 stated that the experience from across Asia indicated
that population policy with government-funded Family Planning program had been a critical
complement to sound economic policy and poverty reduction. They reiterated that large family
size was closely associated with poverty incidence, as consistently borne out by household
survey data over time.
They also noted the following: the Family Income and Expenditures Surveys 5 had
unambiguously shown that poverty incidence was lower for families with fewer children but
rose consistently with the number of children. Among families with one child, only 2.9 percent
were poor compared with households that had nine or more children where 46.4 percent were
impoverished.5 The poor preferred smaller families, except that they were unable to achieve
their preference. The poorer the household, the higher the number of “unwanted”children. In
contrast, among richer families there was virtually no difference between actual number of
children and “wanted” number of children.
Contraceptive use remained disturbingly low among poor couples because they lacked
information and access. For instance, among the poorest 20 percent of women, over half did
not use any method of family planning whatsoever, while less than a third used modern
methods.6
Lack of access to contraception had important health implications. The maternal mortality rate
(MMR), already high at 162 per 100,000 live births in 2006, 6 rose further to 2213 making it
highly unlikely that the Philippines would meet Millennium Development Goal No. 5 by 2015.
From 11 women daily dying due to pregnancy and childbirth-related causes based on the 2006
MMR, this number had risen to at least 15 maternal deaths daily as of 2011.
The risks of illness and premature deaths for mother and child alike were known to be
increased when mothers, especially young mothers, had too many children that were spaced
too closely. Moreover, many unwanted pregnancies resulted in induced and unsafe abortions,
numbering 560,000 annually as of 2008. 7
Almost 25 percent of less-educated teenagers began childbearing compared with only 3
percent of those who had attended college or higher. The pregnancy rate among teen-aged
girls rose from 39 per 1,000 women in 2006 to 54 more recently.3
Parents, who were able to space their children and achieve their desired number, were also
more likely to bear the full cost of raising, educating and keeping them healthy. In contrast,
poor families that had more children than they desired were constrained to rely on public
education and health services and other publicly provided goods and services. Moreover,
women who had children sooner than planned were rarely in the best of health during
pregnancy and were more likely to seek medical treatment. And poor women typically utilized
public health care facilities. In a situation where government was already hard-pressed to
finance even the most basic items of public spending, having no national population policy was
an unnecessary encumbrance. Providing services for planning and spacing pregnancies was,
thus, one way of alleviating the tax burden.
All told, the UP economists believed that RH and FP programs would offer a win-win solution.
These programs would lift the well-being of individual women and children, and benefit the
economy and the environment as well.
Counter-arguments
It is a pity that the debate has been confined to contraceptives because the other elements of
RH, which will similarly protect and promote the right to health and reproductive self-
determination, have been largely ignored.
Dean Tony La Vina of the Ateneo School of Government8 has this to say about the Reproductive
Health Law: “Among others, it is clear that abortifacient methods are prohibited, freedom of
conscience is respected, and there is neither a mandate to reduce our population nor a
preference for smaller families.”
In his view, the RH Law’s most important provision is the guarantee by the State to provide
“universal access to medically-safe, non-abortifacient, effective, legal, affordable, and quality
reproductive health care services, methods, devices, supplies which do not prevent the
implantation of a fertilized ovum and relevant information and education thereon according to
the priority needs of women, children and other underprivileged sectors.”
The RH Law does not set demographic or population targets, and in fact, states that the
mitigation, promotion and/or stabilization of the population growth rate is incidental to the
advancement of reproductive health. Further, each family has the right to determine its ideal
family size.
Religious freedom is actually respected in the RH Law. Hospitals owned and operated by a
religious group do not have to provide services contrary to its beliefs. The conscientious
objection of a health care service provider based on his/her ethical or religious beliefs is also
respected, accompanied by an obligation for referral.
The Asian Forum of Parliamentarians on Population and Development9calls the enactment of
the RH Law “a huge leap for the Philippines towards achieving its commitment to the
International Conference on Population and Development Programme of Action.”
It has been argued that not having a reproductive health law is cruelty to the poor. The poor
are miserable because, among other reasons, they have so many children. Providing
reproductive knowledge and information through government intervention is the humane thing
to do. It can help the poor escape the vicious cycle of poverty by giving them options on how to
manage their sexual lives, plan their families and control their procreative activities. The phrase
"reproductive rights" includes the idea of being able to make reproductive decisions free from
discrimination, coercion or violence.
If the bill then, or the law now, is highly controversial, as the argument has been made, it is not
because it is dangerous to humans or to the planet. It is not subversive of the political order. It
is not a fascist diktat of a totalitarian power structure. The reason the bill or the law is
emotionally charged is because of the fervent opposition of the Catholic Church in the
Philippines and those who wish to be perceived as its champions.
Filipinos in Surveys Favor an RH Law while Roman Catholic Church Opposes
The law, it may be argued, enjoys wide and increasing support from the citizenry. By 2011,
surveys showed that nearly eight out of ten adult Filipinos favored a passage of the RH Bill,
supported the provision of RH education to all and of free RH goods and services to the poor. 10
Most Filipinos, regardless of religion, were reported to be in favor of RH: in June 2011, Social
Weather Stations, a survey group,10 reported that 73% of Filipinos wanted information from the
government on all legal methods of family planning, while 82% said family planning method
was a personal choice of couples and no one should interfere with it. An October 2012 survey
among young people aged 15 to 19 years old in Manila showed that 83% agreed that there
should be a law in the Philippines on reproductive health and family planning. 11
Over 80% of Filipinos identify themselves as Catholic; but their attitudes, as reflected in the
surveys,and practices indicate widespread rejection rather than acceptance of Catholic teaching
on contraception and sterilization. It has been pointed out that, 12 as a percentage of their
totals, more Catholics than non-Catholics supported the RH Bill. The debates were fiery and
painful but demonstrated that the only real objectors were the Catholic bishops and their
staunch followers who insisted on their established position against modern family planning
(FP) methods, i.e., “artificial” contraceptives.
Apart from the Catholic Church, all other major religions in the Philippines supported the RH
Bill.13,14,15 Support also came from the Interfaith Partnership for the Promotion of Responsible
Parenthood, the National Council of Churches in the Philippines, the Iglesia ni Cristo, and the
Philippine Council of Evangelical Churches.
The position of these Christian bodies was supported by the Islamic clerics in the Philippines. In
2003,16 the Assembly of Darul-Iftah of the Autonomous Region of Muslim Mindanao issued
a fatwah or religious ruling called "Call to Greatness." It gives Muslim couples a free choice on
whether to practice family planning.
During the debates on the bill then, and even the law now, it may be said that serious
discussion is encumbered by deliberate disregard or misrepresentation of scientific evidence
and information, and the penchant of parties in the debate to calling each other names such as
“proabortion,” “anti-life” and “immoral” on the one hand and “bigoted,” “antipoor” and
“intolerant” on the other.
As of the time of writing of this article, with the status quo ante (restraining) order by the
Supreme Court – a setback, if temporary, for the new RH law – it may be said that the war for
reproductive health rights in the Philippines has not yet been won.
Jean Gray Marasigan
STEM 12-A
